DUTIES AND RESPONSIBILITIES
Responsible for the analysis of client records to determine legitimacy of admission, treatment and length of stay in psychiatric health-care facility to comply with government and insurance company reimbursement policies and standards.
Writes policies and procedures for the Utilization Review Department.
Complies inpatient medical records to established criteria and confers with medical and nursing personnel and other professional staff to determine legitimacy of treatment, length of stay and discharge plans. Abstracts data from records and maintains statistics.
Assists review committee in planning and holding federally mandated quality assurance
Supervises and coordinates activities of utilization review staff.
Supports Administration in a leadership role.
The above statements are only meant to be a representative summary of the major duties
and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job related tasks other than those stated in this description.
Graduate from an accredited school of nursing
Current registered nurse license in the State of Louisiana.
Recent Utilization Review related experience, psychiatric preferred.
Knowledge of coding, computer software applications, and discharge planning preferred.